How Does Food Accessibility Shape the City Food Landscape? Socio-Economic Inequalities in the Metropolitan Region of Rome

Food insecurity is not merely an outcome of individual deprivation but a place-based expression of how urban food systems operate within unequal socio-spatial contexts. Using the Drivers–Pressures–State–Impacts–Responses (DPSIR) framework as a policy-relevant analytical lens, this study examines the Metropolitan Region of Rome to show how structural inequalities and uneven food infrastructures shape exposure to food-related risks. The results show that vulnerability is amplified by food price inflation, the rising cost of a healthy diet, and spatial gaps in retail provision—captured through the combined presence of food deserts and food blackouts—disproportionately affecting peripheral municipalities. State indicators, including the Food Insecurity Experience Scale (FIES), the Food Affordability Index (FAI), and the spatial distribution of FEAD beneficiaries, reveal a markedly uneven geography of food poverty, mirroring a higher prevalence of overweight, obesity, and diabetes. These spatial configurations point to obesogenic environments in which constrained affordability and limited accessibility restrict the capacity to maintain healthy diets, generating hidden social and health costs that disproportionately burden peripheral areas. Overall, food insecurity in Rome follows a pronounced centre–periphery gradient rooted in structural and institutional arrangements rather than incidental variation. Addressing this condition requires place-based, justice-oriented interventions that strengthen food infrastructures, improve coordination across governance scales, and place food security at the core of an integrated metropolitan Food Policy.